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Multicenter Study
. 2018 Jun 15;8(7):61.
doi: 10.1038/s41408-018-0093-4.

Early BCR-ABL1 decline in imatinib-treated patients with chronic myeloid leukemia: results from a multicenter study of the Chinese CML alliance

Jingru Zhang  1 , Yingqiao Wang  1 , Jianxiang Wang  2 , Jianda Hu  3 , Suning Chen  4 , Jie Jin  5 , Ting Liu  6 , Jianfeng Zhou  7 , Yu Hu  8 , Daoxin Ma  9 , Xiaojun Huang  10 , Chunyan Ji  1 , Ming Hou  1
Affiliations
Multicenter Study

Early BCR-ABL1 decline in imatinib-treated patients with chronic myeloid leukemia: results from a multicenter study of the Chinese CML alliance

Jingru Zhang et al. Blood Cancer J. .

Abstract

An early molecular response is spectacularly predictive of outcome in chronic myeloid leukemia (CML) and early response landmarks may identify the high-risk patients likely to be benefit from an early therapy switch. In this study, we evaluated the most relevant cutoffs for early molecular response markers (BCR-ABL1 values at 3 months, log reduction and halving time between diagnosis and 3 months) in 476 first-line imatinib-treated Chinese patients with chronic phase CML. All outcomes were significantly superior for the 324 patients with 3-month BCR-ABL1 ≤10%, so did for the 270 patients with BCR-ABL1 >0.61 log reduction. BCR-ABL1 halving time ≤22 days was identified for patients with the most favorable outcome. Moreover, the prognosis was significantly poorest for patients with both halving time >44 days and BCR-ABL1 >10%. Importantly, multivariate regression analysis demonstrated that a BCR-ABL1 log reduction calculated at 3 months of 0.61 was the only variable that significantly predicted for OS. Our results highlight the importance of rapid initial decline of BCR-ABL1 in predicting satisfactory outcome. Our data support the evidence that monitoring BCR-ABL1 values at an early time point could contribute to accurately assess response and ultimately guide clinical decisions regarding the timing of therapeutic intervention.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1. Outcomes according to 3-month BCR-ABL1 value.
a OS, b PFS, c EFS, d FFS, e CCyR, f MMR, and g MR4.5
Fig. 2
Fig. 2. Outcomes according to BCR-ABL1 log reduction.
a OS, b PFS, c EFS, d FFS, e CCyR, f MMR, and g MR4.5
Fig. 3
Fig. 3. Outcomes according to both 3-month BCR-ABL1 value and log reduction.
a OS, b PFS, c EFS, d FFS, e CCyR, f MMR, and g MR4.5
Fig. 4
Fig. 4. Outcomes according to BCR-ABL1 halving time.
a OS, b PFS, c EFS, d FFS, e CCyR, f MMR, and g MR4.5
Fig. 5
Fig. 5. Outcomes according to both 3-month BCR-ABL1 value and halving time.
a OS, b PFS, c EFS, d FFS, e CCyR, f MMR, and g MR4.5
See this image and copyright information in PMC

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